Exercise and Musculoskeletal Health in Men With Low Bone Mineral Density: A Systematic Review

Area of Science:

• Exercise physiology
• Gerontology
• Bone and mineral metabolism

Background:

• Low bone density, including osteoporosis and osteopenia, is a significant health concern for men.
• Sarcopenia, the age-related loss of muscle mass and strength, often coexists with low bone density.
• Effective interventions to improve bone and muscle health in men are crucial for maintaining function and preventing fractures.

Purpose of the Study:

• To systematically review the effects of various exercise modalities on bone and muscle health in men diagnosed with low bone density.
• To identify the most effective exercise interventions for improving bone mineral density, muscle mass, and functional outcomes.

Main Methods:

• A comprehensive electronic literature search was conducted across multiple databases (Medline, AMED, Embase, Scopus, SPORTDiscus) from January 1940 to September 2021.
• Included studies were randomized or non-randomized trials involving adult men with osteoporosis or osteopenia, assessing bone or muscle health outcomes.
• Data extraction and quality assessment (using TESTEX) were performed by two independent reviewers, with 13 eligible articles identified from 6 unique trials.

Main Results:

• Resistance training demonstrated the most significant benefits, stimulating muscle replacement of adipose tissue and, in some cases, improving bone density.
• Exercise interventions, especially resistance training, were effective in slowing the progression of osteoporosis and sarcopenia in men.
• Improvements in functional outcomes, such as enhanced mobility and balance, were observed with exercise.

Conclusions:

• Resistance training is a highly effective exercise modality for improving bone and muscle health in men with low bone density.
• Exercise interventions can mitigate the progression of osteoporosis and sarcopenia, leading to better functional capacity.
• While other modalities like whole body vibration and traditional Chinese exercises showed minimal benefits, resistance and impact training appear most promising.